Molecularly targeted therapy: toxicity and quality of life considerations in advanced colorectal cancer

Abstract

Colorectal cancer (CRC) is the third most common malignancy and cause of death from cancer among adults worldwide. In recent years, the use of 5-fluorouracil-based regimens in combination with molecularly targeted agents has greatly expanded treatment options for patients with metastatic disease. With a more capillary use of this new class of agents comes the recognition of diverse adverse events related to disturbance of critical biological pathways involved in physiological functions. Proactive management and prevention of adverse events, with a focus on the necessary compromise between adverse events and tumor control, are often effective and allows for uninterrupted, full-dose therapy with targeted agents. Quality of life does not appear deteriorated, rather improved due to efficacy in prolonging wellness.

Keywords::

• colorectal cancer
• targeted therapies
• therapeutic choices
• toxicity
• quality of life

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Colorectal cancer is the third most common malignancy and cause of death from cancer among adults worldwide.

• • The use of 5-fluorouracil-based regimens in combination with molecularly targeted agents, such as the anti-VEGF antibody bevacizumab and the anti-EGFR antibodies cetuximab and panitumumab, has greatly expanded treatment options for patients with metastatic disease.

• • Molecularly targeted agents are responsible of diverse adverse events related to disturbance of critical biological pathways involved in physiological functions.

• • Toxicities usually associated with chemotherapy, such as nausea and vomiting, alopecia or neutropenia, are rarely reported in patients treated with targeted therapies, in which a wide range of vascular, cardiac, gastrointestinal and skin toxic effects frequently occur.

• • Proactive management and prevention of adverse events, with a focus on the necessary compromise between adverse events and tumor control, are often effective and allows for uninterrupted, full-dose dose therapy with targeted agents.

Notes